PLAY

the person is alert and oriented, attends to your questions and responds appropriately

Skin color

color tone is even, pigmentation varying with genetic background, skin is intact with no obvious lesions

Facial features

facial features are symmetric with movement

BODY STRUCTURE

stature, nutrition, symmetry, posture, position, body build contour

Stature

the height appears within normal range for age, genetic heritage

Nutrition

the weight appears within normal range for height and body build; body fat distribution is even

Symmetry

body parts look equal bilaterally and are in relative proportion to each other

Posture

the person stands comfortably erect as appropriate for age. note the normal "plumb line" though anterior ear, shoulder, hip, patella, ankle. expectations are the standing toddler who has a normally protuberant abdomen and the aging person who may be stopped with kyphosis.

Position

the person sits comfortably in a chair or on the bed or examination table, arms relaxed at sides, head turned to examiner

normally, the base is as wide as the shoulder width; foot placement is accurate; the walk is smooth, even, and well-balanced; and associated movements, such as symmetric are swing, are present

Range of motion

note full mobility for each joint and that movement is deliberate, accurate, smooth, and coordinatedno involuntary movement

BEHAVIOR

facial expression, mood and affect, speech, dress, personal hygiene

Facial expression

the person maintains eye contact, expressions are appropriate to the situation

Mood and Affect

the person is comfortable and cooperative with the examiner and interacts pleasantly

Speech

articulation is clear and understandablethe stream of talking is fluent, with an even pacethe person conveys ideas clearlyword choice is appropriate to cultrue and educationthe person communicates in prevailing language easily by himself or herself or with and interpreter

Dress

clothing is appropriate to the climate, looks clean and fits the body, and is appropriate to the person's culture and age-group

personal hygiene

the person appears clean and groomed appropriately for his or her age, occupation, and socioeconomic group.hair is groomed, brushed, women's makeup is appropriate for age and culture

MEASUREMENT

Weight, height, body mass index, waist circumference

Weight

use balance or electronic standing scale. remove shoes and heavy clothing. record in kilograms and in pounds

Height

use wall mounted device or measuring pole on the balance scale. align with top of head, shoeless,l standing straight, looking straight, feet, head and shoulders should touch hard surface

Body mass index

practical marker of optimal healthy weight for height and and indicatior of obesity or malnutrition. healthy is level of 19 or greater to less than 25

Note: BMI overestimates body fat in persons who are very muscular, and it underestimates body fat in older adults who have lost muscle mass

What is the BMI formula?

weight (in pounds)/height (in inches)^2 X 703

Weight (in kg)/height (in meters)^2

Waist circumference

with person standing, locate the hip bone and the top of its right iliac crest. place measuring tape around the waist, parallel to the floor, at the level of the iliac crest.

VITAL SIGNS

Temperature, pulse, respirations, blood pressure

What is normal oral temperature of resting person? How much higher does rectal temp measure?